Submission to Labour Party Policy Commission on Health and Social Care

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The SHA held a Policy Forum on January 11th in Durham open to SHA members, Labour Party members and other sympathetic health experts. The meeting was sponsored by Unite. 45 people attended, including health professionals, trade unionists, councillors, activists, academics and NHS Governors and Lay Representatives. The conclusions are presented under the categories used in the Labour Party “Final Year Document”. Some points fit into more than one category.

(a)             Whole Person Care

  • Integration between health and social care should focus on the person not the organisation.  Labour’s “Every Child Matters” onion was a good model.  Needs based not service based assessments.
  • There needs to be integration at the top – Northumbria Care Trust has a senior member of social services on the board. Co-location at the grass roots is the best determinant of working together.  Was tried in Co Durham and in North Wales.
  • Social model for people (not just elderly) with long term conditions.  Best way to break down professional barriers and avoid another re-organisation is for Health and Wellbeing board to hold budget.  There needs to be more Public and Patient Engagement with HWBs.
  • Labour Councils should be trying out ideas to integrate services wherever possible.  The Easington Healthworks model is a good example. Integration not just of health and social care but also housing and leisure services.

(b)  Mental Health

  • There needs to be better access to “talking therapies”.
  • There needs to be better discharge care for mental patients.
  • There is at present a gap between years 16 and 18 for young people.
  • Public Health does not include a mental health strategy.  Concentrates on physical well being.There should be preventative strategies for mental illness.
  • Cuts in benefits and measures such as the bedroom tax directly affect mental health.
  • There should be more integration of mental health into the system.

(c ) Public Health

  • More efforts should be made to enable people to take care of their own health.  The Easington Healthworks model should be rolled out.  It is a health resource – a partnership between the NHS, the Local Authority and the community.67 volunteers are involved.
  • There needs to be more encouragement of sport and exercise –partnership working, social prescribing.
  • Labour has to become more the party of the consumer.  We need to take tougher action against food and drink companies.  Changes to be introduced gradually so they are not noticed so much.
  • Must be effective action on health inequalities.
  • The social model of health. Health linked to other factors, e.g. bad housing unemployment.

(d)            Our NHS

  • More attention should be given to primary care.
  • The NHS is efficient.  Privatisation leads to more admin costs – checking and ensuring compliance.  More jobs for lawyers.  If it needs resources the idea of hypothecated taxation should be explored.
  • Selling off social care was a mistake.  Existing contracts need to be strictly monitored and taken back in house or given to social enterprises.
  • We should consider the Welsh and Scottish systems which do not have purchaser/provider split.
  • More democratic control and accountability.  Accountability is not the same as engaging people.  More effort needs to be done to ensure this, particularly if change is to be accepted.
  • Some Tory councils may do things we do not like, or not do anything at all, but that is the price of democracy.

Overall points

  • We do not want another reorganisation.  The best way to secure integration is through strengthening Health and Wellbeing Boards.
  • Integration is not just health and social care.  It is also housing and leisure services.  Another reason for using the HWBs.
  • We cannot continue to provide sub-standard cut price social care.  If more resources are needed then we must consider hypothecated taxation.
  • We need to make it clear we believe in the NHS, as distinct from the Tories who do not (whatever they say).
  • Ordinary people should be more engaged with the NHS, and this is particularly necessary if we are going to explain reconfigurations and take people with us. This requires resources and efforts.  The Northumbria Trust is a good example.